ANZCTR search results

Hamstring tightness and insertional tendonopathy is a common condition that frequently coexists with osteoarthritis about the knee. Total knee arthroplasty (TKA) is the definitive treatment of advanced symptomatic knee ostoearthritis but does nothing to treat hamstring tightness and insertional tendonopathy which can then interfere with the recovery from TKA by causing pain and altering gait mechanics. Little data exists on the coexistence of these two conditions however. The author proposes a prospective randomized blinded trial to assess the effect of hamstring stretching on knee extension angle,gait, fixed flexion deformity and symptoms in the osteoarthritic knee and to assess the effect of hamstring stretching the same parameters after TKA. Patients presenting to participating orthopaedic surgeons for treatment of knee osteoarthritis with flexion, varus or flexion and varus deformity >= 10 degrees and scheduled for TKA will be eligible for enrollment in the study. Clinical assessment of the knee, gait analysis and validated outcomes scores to be assessed at time zero, after four weeks of stretching and six weeks after TKA. Final examination and scoring at 6 months post op. Symptoms to be assessed using standardized assessment forms (Euroqual, WOMAC, Oxford Knee Score, Knee Society Knee Score, KOOS). Unilateral TKA participants will be randomly allocated to either a control (CTKA) or treatment (TTKA). Bilateral TKA patients will also be randomly allocated to either a control (CTKA) or treatment (TTKA).The TTKA treatment groups will undergo a stretching program 4 weeks before and 6 weeks after TKA surgery. The Participants will be instructed in performing a hamstring stretch by a physiotherapist. Participants will be required to perform a 2 x 2 mins progressive hamstring stretches twice daily (total of 8 min hamstring stretch on each leg). Instruction video to be provided to each patient on portable USB drive. Reminder text messages twice weekly to be sent. Gait lab technician and clinical assessor and inpatient physiotherapist to be blinded.

In Rockhampton 64.1% of adults are overweight or obese and half of the adults do engage in sufficient levels of physical activity (PA) to achieve health benefits. A new partnership between Queensland Health, Central Queensland University and the Rockhampton Regional Council the biggest employer in the region, may improve the health of workers by introducing the 10,000 Steps Workplace Challenge. The effectiveness of this program will be studied. We will examine whether the 10,000 workplace challenge increases physical activity, reduces total sitting time, reduces obesity, and increases quality of life. The benefits may extend to a reduction in chronic disease and health care costs within the Central Queensland Hospital and Health Service.

Approximately 20-40% of all pregnancies end in miscarriage. In patients undergoing IVF treatment for infertility this rate is compounded by a high rate of embryo implantation failure. Based on data collated in the most recent ANZARD report, only 28% of the 50,495 embryo transfer cycles that took place in Australia/ New Zealand in 2008 resulted in a clinical pregnancy, and approximately 1 in 5 of these pregnancies ended in miscarriage. Despite numerous tests available to try and diagnose the cause of miscarriage (mostly involving the genetic diagnosis of chromosomal abnormalities), there are few treatment options available for this patient demographic. EmbryoGen 'Registered Trademark' is the first embryo culture media to show an improved live birth rate in women who have previously experienced miscarriage. We wish to see if this applies to patients undergoing treatment at PIVET Medical Centre

Stroke is a major health problem in New Zealand and internationally. Current educational tools for stroke survivors and their caregivers remain inadequate and there are major gaps in the ability of the existing educational tools to transfer knowledge about stroke risk factors, warning symptoms, treatment, caregiving and rehabilitation. New technology allows more personal, engaging educational strategies that can be delivered interactively. This randomised controlled trial is to assess the feasibility of a novel observational learning DVD-based educational intervention in stroke survivors and their caregivers as a potentially applicable strategy to improve the function of stroke survivors as well as the health and well-being of both survivors and informal carers. Should this unique role model DVD-based observational learning tool be effective in improving outcomes in stroke patients and their caregivers, it will be a significant advance in stroke care.

Head injury is a very common presentation to emergency departments (EDs). Up to 15% of patients with mild head injury experience persistent disabling problems (e.g. reduced cognitive and functional ability, heightened emotional distress, and delayed return to work or school). As the ED is the main, and often only, point of medical contact for these patients, the care they receive in the ED can impact on these patients’ outcomes. The NET-Trial is a cluster randomised trial which aims to test the effectiveness of a targeted, theory and evidence-informed implementation intervention regarding the management of adult mild head injured patients in the ED in Australia. Three recommendations from clinical practice guidelines have been selected as the focus of the study and they are 1) prospective assessment for post traumatic amnesia (PTA) using a validated tool; 2) appropriate computed tomography (CT) scanning based on risk criteria; and 3) the provision of patient information upon discharge from the ED. The 3 key evidence-based recommendations have been decided after a systematic review of the evidence and available clinical guidelines, and consultation with the ED community. EDs will be randomised to receive either the intervention or to a control group who will have access to the clinical practice guideline alone. The control group will be offered to receive the intervention component of the study following data collection. In addition, EDs will be invited to participate in the “NET-Plus” trial that also includes patient outcomes to investigate whether improved management as a result of our intervention is translated into improved patient outcomes.

Obstructive sleep apnea syndrome (OSAS) is composed of sleeping apnea and hypopnea. It also accompanied with fatigue, daytime sleepiness and poor concentration and memory in such patients. The standard treatment for it is usage of continuous positive airway pressure during sleeping. In this study, we want to know condition of Traditional Chinese Medicine (TCM) constitution in patients with OSAS, and to see if treatment of CPAP improves patients' TCM constitution.

People with LBP are often anxious, catastrophise about the consequences of LBP, and are fearful of movement and re-injury. Increased fear is associated with more time off work, and the progression of an acute episode of LBP to chronic disability. Health Care Practitioner (HCP) attitudes and beliefs are associated with the attitudes and beliefs of their patients. Numerous guidelines have been developed to try and improve the management of LBP and prevent progression to disability. When these guidelines are followed patients have better outcomes at lower cost. However, the development and implementation of these guidelines has not decreased the financial and social burden of LBP. Although this may be due to a number of factors, the attitudes and beliefs of both HCPs and their patients, and the interaction between these two groups, are important contributors. The Fear Reduction Exercised Early (FREE) approach will communicate current best practice to GPs and their patients by using a novel information package. This aims to influence the attitudes and beliefs of both GPs and their patients, providing them with a consistent framework upon which to achieve optimal management of LBP. This trial will test the acceptability and utility of the FREE approach amongst a cohort of General Practitioners.

70% of children experience significant pre-operative anxiety and their anxiety levels peak at the time of mask induction. This study aims to familiarise children with the anaesthesia face mask prior to induction of anaesthesia with a cheap and readily available intervention: a playful, song based video that children will enjoy watching.

The aim of this NHMRC-funded study is to answer an important question in the treatment of moderate-to-severe youth depression: should antidepressant treatment be started as a first-line treatment, concurrent with psychotherapy? The question has taken on increased clinical importance in the wake of recent evidence questioning the efficacy and safety of antidepressants in young people, and the subsequent development of treatment guidelines for youth depression that provide only qualified support for their use. This proposal aims to address the need for studies of effective treatments for youth with moderate to severe major depressive disorder (MDD). Patients between the ages of 15 and 25 will be randomised to receive either (i) cognitive behavioural therapy (CBT) and fluoxetine, or (ii) CBT and placebo, for 12 weeks in a double-blind, randomised controlled trial (RCT), with followup to 26 weeks. This will be the first placebo-controlled study that has examined whether the addition of medication to CBT is a more effective strategy than the provision of CBT alone for the treatment of youth depression. The primary hypothesis is that young people with moderate to severe MDD will show greater improvement after 12 weeks of treatment with CBT and fluoxetine (CBT+FLX) compared to treatment with CBT and placebo (CBT+PBO). The primary outcome measure is change in the MontgomeryAsberg Depression Rating Scale (MADRS), an observerrated depression scale that is widely used in depression treatment trials, being both easy to administer and psychometrically sound (Montgomery & Asberg, 1979). Our secondary hypotheses are that the CBT+FLX group will show greater improvement compared to the CBT+PBO group on efficacy, functioning, quality of life, and safety measures at 12 weeks, but that the differences between groups will not be sustained at 26 weeks.

Obstructive sleep apnea syndrome (OSAS) is composed of sleeping apnea and hypopnea. It also accompanied with fatigue, daytime sleepiness and poor concentration and memory in such patients. It was known that OSAS is associated with higher occurrence of cardiovascular disease. In traditional Chinese medicine aspect, OSAS has three major subtypes and has corresponding treatment. In this study we will observe on their TCM constitution and their cardiovascular complications in patients with OSAS.